Thank you so much. Off on a 5 week RV trip starting 7/19, looking forward to incorporating PHD on the road….will be a challenge. Already freezing rice in my seal-a-meal, as well as meat that I know the source….never know what you can find in these small towns. But heck you can only carry so much weight in the rv.
Warm Regards to you both, Donna

I have your book and have been following the diet with good results. Just 2 questions: 1) In the book you say that white rice is ok but you are promoting brown rice pasta on you site. So why is brown rice pasta ok? 2) In your book you say the jury is still out on quinoa. Any updates on Quinoa?
Thanks,
Carol Wright

The oysters you link to above are imported from South Korea — so I assume they are Pacific, not Atlantic, oysters. Pacific oysters provide zinc:copper in roughly a 10:1 ratio (as opposed to 20:1 for Atlantic oysters).

Judging from the discussion in the book, we want roughly a 7:1 ratio of zinc:copper from the diet overall. So if we meet our zinc requirements from Pacific oysters, we also essentially meet our copper requirements.

But if we eat 1/4 pound of ruminant liver on top of the Pacific oysters, do we then run the risk of copper toxicity? (Or need additional zinc supplements to bring zinc:copper into proper balance?)

I used to enjoy the upper mass market brands that people are recommending here, but then I tried some of the incredible chocolate available at a store in Manhattan (that delivers, if you’re not in NYC or don’t have a similar source), and I just can’t go back. They’re more expensive, but I just eat less, a small square a day.

I’ve only just begun my high end chocolate exploration, but so far Akesson’s is one of my favorites and Amma has a wonderful 100% chocolate, something I thought I’d never say.

I noticed that you have the Kirkland seasoned seaweed on here which has corn oil and grape seed oil in it. Do you not worry about polyunsaturated fats when they’re in small quantities in otherwise healthy foods like this? Just curious. For example I know there’s some canola oil in Udi’s bread which I use on a semi-regular basis (probably about five slices a week) but I assume it’s an acceptable compromise because it keeps me away from bread and is convenient. Does this basically fall under the 80/20 rule?

Hi Paul,
According to your book ketogenic diets may help me sort out my infections and some neurological disorders.
Unfortunately keto diets seem to trigger panic attacks in me for unknown reason. Have you heard of other people like that, what’s a possible work around?

Being too low carb can often trigger anxiety, the panic may be a more extreme anxiety. It’s rare for a ketogenic diet to be optimal for infections, more common with neurological disorders, but if it causes panic it’s probably not right for you. I would focus on immunity and gut microbiome improvement.

Paul,
Do you mean that full ketogenic diet is actually inferior for SIBO and autoimmune issues compared to low carb + safe starches?\
Isn’t the SIBO and SIFO going to feed on that resistant starch as well?

It depends. They could be, they might not be. Pathogens that have evolved to infect humans successfully have evolved ways to divert immunity away from themselves toward innocent or beneficial bystanders. Sometimes relieving the inflammation can be helpful.

Powerful anti-inflammatories like prednisone are likely to be harmful. Mild anti-inflammatory probiotics like Lactobacillus reuteri may be helpful.

Hey Paul,
I noticed in your book you recommend sun-dried tomatoes as a source of potassium. Sun-dried tomatoes also contain a lot of sodium (almost as much as potassium) according to nutritiondata. Doesn’t sodium actually increase potassium excretion? Thank you.

Hey Paul,
I implemented the ketogenic diet from your book with a decent amount of safe starches and ketones in my urine are WAY high – 100mg/dl. Is that normal and is it toxic for the kidneys? Also I was wondering if I keep consuming large amounts of MCT oil (up to 9 tbps per day) isn’t that going to affect my cholesterol and triglycerides negatively?
Thanks.

Cut back on MCT oil until ketones go to zero or almost zero. That will be the right amount of MCT oil for you. Possibly you may want to increase starches too. It is not immediately toxic for the kidneys so far as I know, but it does put you at risk of kidney stones, and it demonstrates that you are eating too many calories. You want to minimize calorie intake. If your body is peeing away calories in the form of ketones, you are eating more calories than your cells can use.

Also, are you diabetic? Then you have to be careful to eat enough starches to prevent ketoacidosis. In diabetes you have less control over what your body is doing.

Vegetarianism already cuts out a number of foods you seem to highly value, like seafood, liver, and joint/bone broth. So I wonder what there still is in milk and eggs that’s irreplaceable?

Is it mainly the loss of egg yolks that makes going from vegetarianism to veganism a complete dealbreaker–and if so, why exactly?

Thinking about milk, some of the nutrients it has in abundance like calcium you could probably get from a mix of vegetables and mineral water. Protein you might source from something like lentils; however, I think the amount of them needed would also force you to have lower-fat diet.

There’s some retinol in milk of course, but I’m not sure whether the amount is that significant. And other fat soluble vitamins such as K2 I suppose you’d just want to supplement.

Certainly you’d have a much more reliable source of trace minerals like, say, selenium while keeping milk and eggs, but perhaps that’s where supplementation would once again come into play.

My question is really just academic – as one might say – but I’m curious anyhow. In any case, I certainly can see how dietary restrictions (of any type) make things a lot harder, even if one makes a serious effort.

Vegetarian diets may reduce cancer risk by 10%, but many cancers vary 20-fold in abundance around the world and overall cancer rates vary several fold. So the effect of getting rid of meat is small compared to other dietary and lifestyle factors. Moreover, the advantage of vegetarian diets seems to be not in the dropping of meat — meat itself seems beneficial for the most part — but in eating extra vegetables and fiber, and avoiding junk food. Thus, pescetarians live much longer than vegetarians: both are similarly health-conscious, but the pescetarians get meat.

PHD, which eschews junk food and includes lots of fiber, will reduce cancer rates by far more than vegetarian diets, I believe.

Paul,
There is growing evidence that because humans produce much less HCL in stomach (compared to carnviourous animals), we can only digest 20-30% of meat and the rest is being decomposed by bacteria which in turn results in the production of toxins like Cadaverine, Putrescine, Nitrosamine etc. All of these are potent carcinogenic agents. What do you think about this?

It’s not true. They do nitrogen balance studies to track where protein goes and at PHD levels of protein intake, it is absorbed and metabolized. At bodybuilder protein intakes more is left for gut bacteria, and we argue against eating such large amounts of protein in the book.

Hello Paul,
I used to be a vegan for 7 years but decided to include meat in my diet again, after reading your book.
I don’t eat too much meat, mostly fish and a little liver and grass-fed beef.
On my last test, uric acid came very high and I don’t even have gout. Later I read that red meats, fatty fish and organ meats are all linked to high uric acid.
What is the solution to this problem?
Thanks.

Sodium deficiency sounds extremely unlikely to be honest. I’ve only heard of some athletes suffering from hyponatremia after extreme exercise loads and drinking too much water. Could be a sodium homeostasis issue though.

In this list, are not mentionned infrared stuff… could you add some references or advise to buy some ?

Instead of specific ref, could you mention the characteristic we want to have for such material (for bright light and for infrared light)? As I live in Europe, sometimes the ref. mentionned are not available…

Lighting is on the circadian rhythms page: http://perfecthealthdiet.com/shop-circadian-rhythms/. At this time I haven’t found readily available commercial products that I feel comfortable recommending. The best solution seems to be custom LED banks. You can also buy red heat lamps, but they throw off a lot of heat.

Hey Paul,
My cousin gifted me with your book and I’m loving every bit of it.
I am a little bit concerned with some recommendations and I would love if you can comment on them:
1. http://aje.oxfordjournals.org/content/173/3/319.long
According to this study – consuming the amount of cholesterol found in just a single egg yolk, appears
to cut a woman’s life short as much as smoking 5 cigarettes a day for 15 years.
Your book recommends eating 3 yolks per day.

3. http://www.ncbi.nlm.nih.gov/pubmed/19755625
This bothers me the most According to this study, these endotoxins weren’t destroyed even after boiling the meat for hours.
In fact even if dead, a large load of endotoxins causes an inflammatory response nevertheless. additionally there is some evidence that
saturated fat seems to increase the toxic load by transporting endotoxins faster and the PHD promotes the consumption of saturated fats.

Hello Paul,
I have read that starvation induces ketosis, and when glucose intake is restored, the body tends to dispose the ketones in the urine.
If this is true, does that mean that the body cannot simultaneously use ketones and glucose for energy? In your implementation of the ketogenic diet, some carbs are included, how does the body manage to use both glucose and ketones in that case?
Thanks.

Hi Peterson, that’s half-true, half-false. Ketones are readily utilized, especially if they are needed, even if glucose is available. The glucose can be stored as glycogen for later use. Ketones are lost in the urine when they have been made in excess of requirements.

Hi Paul
Thanks for your great work.
Have you read the new denise minger article on rawfoodsos website.
I listened to her talking on Ben Greenfield podcast.
It goes against most of what she has believed to be healthy.Article is named IN DEFENSE OF LOW FAT.
Would be interested in your opinion as unfortunately my brain is unable to analyze what she is saying.
Thanks Marcus

Dear Paul,
I used a stevia/erythrtitol blend for a coconut flour carrot cake. Was a great recipe, complete with cream cheese and butter icing.
I recently found online (have not purchased yet) something similar called Lakanto Sweetener. It originated about fifteen years ago in Japan. It is from Monk Fruit and also combines with erythrtitol to form a sugar cup for cup substitute. Do you have any awareness or concerns about using either of these types of products?
With the baking and holidays approaching, I’m looking at healthy safer options.
Maybe you could offer your thoughts? Thanks….
I appreciate all you are doing to keep us informed.
God bless you and your family.

Hi Paul,
In chapter 13 pg. 143, it says that 2 Tbs. of coconut oil provide about 140 calories of MCT (thats if 58% of coconut oil is MCT i guess) and on pg. 158 it says consume short-chain fats 500 calories ( 4 Tbs.) this comes out to 125 per Tbs. and 58%would have been 280 cal.
and on the labels of coconut oil it says 1Tbs. 120-130 ?

The statement on p 158 is a guideline for a ketogenic diet, which requires more oil than we would normally recommend (and that is optimal for long-term health). If you are trying to be ketogenic, you should experiment to minimize the amount of oil you consume.

Now, if you actually buy ‘straight’ MCT oil, it will be 98%+ c8 & c10. They will only contain c12 at trace amounts, less than 1 or 2%.
(i have seen only one exception to this rule; there is one MCT oil product that does contain c12 Lauric Acid at a significant amount).

But why would he change from coconut oil to MCT oil
Darrin, could you please explain this sentence Paul wrote “If you are trying to be ketogenic, you should experiment to minimize the amount of oil you consume.” Thank You

1. i now see that Paul has actually link to MCT oil products in this post above.

2. as Paul says above re the 100% MCT oil products in the post above next to the product links; “The ketogenic benefits of coconut oil in fewer calories” eg. the c8 & c10 oils (Caprylic & Capric) are much more ‘ketogenic’ than c12 (Lauric acid).
& the total c8 & c10 in coconut oil is low, only around 17% combined.
whereas the c8 & c10 in the 100% MCT oil products is nearly 100%.
So based on those numbers, you would have to consume nearly 6x more coconut oil than 100% mct oil to get the equiv c8 + c10 amount.

Have noticed when shopping for organic(how important is pesticide affecting health? ) potatoes and carrots, can smell mold from each package. Since dont do well with potatoes, rice or carrots for that matter, may try the carrot bunch with tops on to see if better.
Am guessing can use other veggies in place of starches till nonreactive?

You can find non-organic foods here which have the most and the least pesticides. The second link provides a list of the non-organic produce that doesn’t require too much pesticides to grow and is considered clean. Example – you don’t need to buy organic avocados, but you definitely should opt for organic strawberries.

I think it is too early to say whether pesticides are a major health risk for people since we don’t have that much data yet. I would avoid them whenever I can though. Mold on the other side is a serious problem. IMO mold is much more dangerous than pesticides. So if your organic seller sells moldy produce you might want to consider changing her or growing some of the stuff yourself – potatoes and tomatoes are rather easy to grow.

Hello Paul,
One wikipedia article explains that some thyroid problems (i.e. hyperthyroidism, thyrotoxicosis) should be treated with inorganic iodide (ideally potassium iodide and not Lugol’s iodine). Can you explain why Lugol’s is not okay for thyroid complications? Is it because it contains elemental iodine and why is that an issue.

Chemically Lugol’s is fine, but the dose is almost always too high. I typically advice people to dilute Lugol’s solution 30:1 (i.e. 1 ounce into 1 quart/liter water) and take one drop per day — that reduces 6 mg to 200 mcg which is a good dose. … For hyperthyroidism however high doses are required for the therapeutic effect. That is a very risky therapeutic approach and do not do it except under the advice of your doctor, and even then I would be skeptical.

Hello Paul,
Can you please explain how did Paleo people manage to avoid tooth plaque? There is some information that Paleo people did not suffer from tooth decay and they didn’t even brush their teeth. In fact brushing teeth doesn’t seem to help with tooth decay in the 21st century especially when on a poor diet.

According to one study 1g of Nori sheet will contain an average of 16mcg of Iodine. This means that about 15g (6 sheets) are required to achieve the minimum daily value of 225mcg.
(Teas, J., Pino, S., Critchley, A., & Braverman, L.E. (2004). Variability of iodine content in common commercially available edible seaweeds. Thyroid 14(10))

I guess my question is this – given that Iodine content of seaweed is highly variable and questionable between samples and studies, how does one ensure a consistent Iodine intake from food alone? What is your strategy to overcome this problem?

Variability of nutritional content is a common feature of natural whole foods, so a certain unpredictability is inevitable. However, for reasons we don’t understand, the body seems to do a much better job of coping with nutrients from natural whole foods than from supplements. It is easier to get health problems from variable intake of supplements than from variable intake of food. Probably the gut is optimized for food-based nutrients and can better modulate absorption as needed.

In regard to iodine, we recommend taking a 150 mcg to 225 mcg daily supplement to even out intake levels by providing a moderately high daily floor, but if you eat seaweed regularly this is not needed. I wouldn’t worry about the variations in iodine content of seaweed, I would just avoid the very high iodine seaweeds like kelp.

Dear Paul,
What is your opinion on all those startups coming up with ways to grow meat artificially in the lab? Do you think synthetic meat will ever be as good as the real thing? Do you think this is a potential threat to health?

Living creatures share a common biology and therefore are composed of a similar set of nutrients. Synthetic meat, while in principle it could be OK, is not constrained to have all the nutrients needed to support a living creature, and therefore is likely to be missing many nutrients. I would look at it as similar to the idea that we should eat insects, because there are so many of them. Yes, it may be a cheaper source of food, but it is a lower quality source of food. As a way of averting starvation during famines it may make a lot of sense. But I wouldn’t give up real food unless I was desperate.

Hey Paul,
Today at the market I saw and bought something called Coconut Chips which is essentially baked organic coconut chips with sea salt and nothing else. Tastes almost like potato chips. Assuming the company is honest this should actually be healthy right? Are we approaching a new era of foods where a new type of healthy “junk” foods will appear? If so that’s a great step for mankind. What are your thoughts on the coconut chips per se? Thanks for your input.

Hi Stan,
I was intrigued by your find and found something of a similar name on Amazon, but noticed cane sugar as the second ingredient. The price scares me more than the sugar, perhaps, but just to say, if this is what you we’re referring to, there is added sugar in addition to salt and coconut.

No, activated charcoal is not carcinogenic as far as I know, but it can induce nutritional deficiencies and disturb the gut microbiome, so unless you have a toxin you know you need to clear from your body, I would minimize or avoid it.

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